The wars are winding down, and veterans are returning home with both mental and physical health conditions. Posttraumatic stress disorder (PTSD) has been the most prevalent mental health disorder among veterans of both the Afghanistan and Iraq wars seen at the Veterans Affairs medical centers. Comorbid pain has accompanied this preponderance of PTSD.
Unfortunately, these young veterans with pain and PTSD are at high risk of prescription opioid misuse when one considers the high degree of substance abuse among veterans with PTSD. An article published earlier this year in the Journal of the American Medical Association examined the effect of mental health disorders, including PTSD, on the patterns of opioid prescription, the risks associated with such prescribing, and the impact of opioids on a more personal level.
Indeed, those Iraq and Afghanistan war veterans with PTSD exhibited higher-risk opioid use, and outcomes such as injuries and overdose. Interestingly, the authors found that veterans with drug and alcohol use disorders were more likely to be prescribed opioids than veterans with no mental health conditions; this was more pronounced among those with a PTSD diagnosis. And veterans with PTSD were at a higher risk of being prescribed more than one opioid simultaneously, and sedatives with the opioids. Unfortunately, the concomitant use of sedatives and opioids results in a higher incidence of overdose.